03 January, 2012

If you light up a cigarette, it will snuff out your chances to land a job with health-insurance giant Humana in Arizona.

The Louisville-based health insurer said Wednesday that it will no longer hire workers in Arizona who smoke cigarettes or use other cigarettes store products, part of a trend of employers who are cracking down on cigarettes use among workers.

To enforce the cigarettes online ban that starts Friday, Humana will test new employees for nicotine use during a pre-employment urine drug screen.

Humana representatives say it makes sense for a company in the health-care field to lead by example. Smoking's harmful effects on human health are well-documented, and Humana seeks to promote health and wellness — starting with its workers.

"Humana is dedicated to helping our employees take charge of their own health," said Dr. Charles Cox, Humana vice president and market medical officer for Arizona, Nevada and Utah.

Humana is part of a growing number of employers, many of them in health care, seeking to ban smoking cigarettes among new hires. The Cleveland Clinic stopped hiring smokers in 2007, and hospitals in several states have stopped hiring tobacco-using employees.

No legal protections

Legal experts say nothing under state law prohibits employers from not hiring smokers.

"Being a smoker is not a category that is protected under the law," said Lisa Coulter, an attorney with Snell and Wilmer in Phoenix.

Coulter said more and more employers are seeking to regulate employees' conduct outside the workplace. Some examples include guidelines that prohibit what an employee can post on a social-media websites such as Facebook or Twitter.

Some employers offer financial incentives or penalties to reduce health-care costs by seeking behavioral changes. Some examples include programs that encourage employees to shed weight, diet, quit smoking cigarettes or manage other risk factors that could lead to costly health conditions such as diabetes or high-blood pressure.

Such "wellness plans" may include tests that can measure things such as whether a person's body-mass index exceeds recommended standards or if cholesterol levels are dangerously high.

"They are trying to get a handle on the cost of health care and health insurance," said Henry GrosJean, a broker for GrosJean and Associates, a benefit-advisory firm.

Employees in Maricopa County, Arizona, recently complained about a new health plan that required them to submit saliva samples to test for nicotine. The employees complained that such testing represented an invasion of privacy. County employees who agreed to take the test and did not have tobacco in their system qualify for insurance premiums that are $480 less than what smokers and those who refused to take the test must pay.

Several Arizona employers have encouraged employees to quit smoking cigarettes through policies that adopt a carrot-and-stick approach. Companies often ban smoking cigarettes at work and offer discounted health insurance for employees who agree to kick the habit. Some employers have assessed a benefit surcharge on employees who continue to use tobacco, according to Blue Cross Blue Shield of Arizona.

Humana representatives said they are merely trying to improve the health of their workers. The company cited Centers for Disease Control and Prevention statistics that show that smoking cigarettes causes about 443,000 deaths each year.

"Cigarette smoking cigarettes increases the risk of cancer and shorten life spans," Humana spokesman Ross McLerran said. "We're trying to provide a workplace that is safe and healthy. We do care about the health of our associates."

Expanding the ban

Humana implemented a tobacco ban for its new employees in Ohio two years ago. The Ohio program did not test for nicotine use among new hires like the Arizona program will, but the company said the effort has worked. In Ohio, 78 percent of Humana's employees report being tobacco-free.

Cox, the Humana vice president, said it selected Arizona to roll out the new program because state laws allow employers to require tobacco-cessation programs. The state's smoking cigarettes rate, 13.1 percent, is also among the lowest in the nation, according to the Arizona Department of Health Services.

"Our new hiring process is how we are going to lead by example," Cox said.

Humana may expand the smoking cigarettes ban to employees in other states, but the company has not publicly announced such plans, he said.

The policy does not apply to employees at the company's headquarters in Louisville, Ky. Kentucky has declared smokers a "protected class," making it illegal to discriminate against people because they smoke. Other states have similar laws.

Humana employs about 1,300 full-time workers in metro Phoenix and Tucson, and the company is hiring 104 full-time employees for its Medicare call center in Phoenix. Those new positions include telesales specialists and supervisors who will sell Humana products nationwide.

Humana's ban for new hires will apply to all tobacco products, including cigarettes, pipes, chewing tobacco and cigars. These workers must agree to abstain from tobacco use while employed by the company. If those new hires start using tobacco, they will be required to self-report their use and enroll in a free tobacco-cessation program that provides counseling and nicotine-replacement products.

Secondhand smoke, that which is inhaled passively by someone who is not smoking cigarettes, might be in a person's system at the time of the drug test, but the test is sensitive enough to distinguish whether a person is exposed to nicotine through secondhand smoke cigarettes or whether the person actually uses tobacco products, a Humana spokesman said.

Although existing Humana-employed smokers aren't required to halt tobacco use, they will be encouraged to do so. Those employees will be offered free stop-smoking cigarettes help, Humana officials said.

Employees who enroll in the smoking cigarettes-cessation plans also are offered discounted medical insurance.